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Mothers again urged to eat fish
Advisory at odds with FDA guidance
By Sally Squires
The Washington Post
Updated:
11:00 p.m. ET Oct 3, 2007
Pregnant and breast-feeding women
should eat at least 12 ounces of fish and seafood per week to ensure
their babies' optimal brain development, a coalition of top scientists from
private groups and federal agencies plans to declare today in a public
advisory that marks a major break with current U.S. health advice.
The scientists' conclusion is at
odds with the standard government advice issued in 2001 that new
mothers and mothers-to-be should eat no more than 12 ounces of seafood
per week because of concerns about mercury contamination.
Shifting data and advice on how
women's consumption of fish and seafood affects brain development of
fetuses and infants, the most vulnerable groups, have produced one of
the more vexing nutritional dilemmas of recent years.
In the short term, at least, today's
statement, drafted by scientists affiliated with multiple medical
organizations, is likely to deepen the dilemma for many women, especially
since the Food
and Drug Administration indicated that it will study
the new information but is not prepared to change the advice it
reiterated in 2004.
'A big debate'
"There is a big debate about what is safe," said Brown
University professor Patricia Nolan, a former
state health officer of Rhode
Island and one of the experts who drafted
the new guidelines. "There are really complex questions. That is
why we are doing this."
At the core of the problem is the
tension between the brain-bolstering nutrients in seafood and concern
over exposure to mercury, which builds up in the tissue of many marine
species and is toxic to nerve tissue.
Practicing physicians such as New
York University obstetrician Ashley Roman, herself
a new mother, expect the questions about seafood and mercury to
intensify.
"Every single day, I get
questions from my patients about this, because it is such a confusing
area," said Roman, who served on the panel that offered the new
advice. "Personally, for me in my practice, it doesn't change what
I have already been recommending, which is to have at least three
servings of fish a week."
The first thing Roman said she tells
her patients is that "fish intake in pregnancy has never been
linked with mercury toxicity" in fetuses or newborns, while
highlighting the benefits to mother and baby.
Omega-3 fatty acids
Fish and seafood are the major dietary sources of omega-3 fatty acids,
especially a substance called docosahexaenoic acid (DHA). They are key
nutrients for the brain and nervous system in developing fetuses,
infants and young children.
The advisory set to be released
today at a Washington news conference comes from the National Healthy
Mothers, Healthy Babies Coalition. The coalition is a nonprofit group
with nearly 150 members, including the American
Academy of Pediatrics and the March
of Dimes, as well as federal agencies
including the National Institute of Child Health and Human Development
and the Centers
for Disease Control and Prevention.
Concerns about mercury contamination
prompted the FDA and the Environmental
Protection Agency to issue consumer advisories in
2001 and again in 2004. Pregnant
and breast-feeding women, those who want to become pregnant, and young
children were told to eat no more than 12 ounces weekly of fish or
seafood, a number based on theoretical calculations of the potential
for contamination.
The FDA
and EPA also recommended that these
groups avoid eating shark, tilefish, king mackerel and swordfish
because of high mercury content, and to eat no more than six ounces per
week of albacore tuna. The agencies say that for most other people, the
mercury in fish and shellfish poses no risk.
Consumers seemed to take that advice
to heart and were reinforced by the popular self-help book "What
to Expect When You're Expecting," which said that when it comes to
fish, pregnant women, as well as nursing moms and young children,
"should play it safer than the general population."
The federal seafood warning led 56
percent of pregnant women to cut fish consumption to levels well below
beneficial amounts, according to a study conducted earlier this year at
the Medical University of South Carolina.
When women skimp on fish, dubbed
"brain food" by previous generations, their babies and
children can sometimes pay the price, other studies indicate. Earlier
this year, a team of British and American scientists reported in the
Lancet that children of women who ate the smaller amounts recommended
in the United States during pregnancy had lower IQs and lower academic
test scores at age 8, and more behavioral and social problems
throughout early development, than youngsters whose mothers ate 12 or
more ounces per week.
Other studies suggest that missing
out on the high levels of omega-3 fatty acids found in fish can
increase the risk of delivering a baby too early and at a low birth
weight.
Depression risk
It's not just babies and children who may be harmed by
inadequate consumption of seafood. Mothers who do not get enough
omega-3s in pregnancy seem to have a higher risk of depression while
expecting and after giving birth. Postpartum depression afflicts about
one of every 10 new mothers, said James McGregor, a University
of Southern California obstetrician who headed the
Maternal Nutrition Group that drafted the new guidelines.
Some countries and governmental
groups, including the United
Kingdom, Australia, Belgium, the
Netherlands and the Nordic Council of
Ministers, already advise that pregnant women eat at least two servings
of fish per week.
The latest recommendations add to a
growing call for consuming more omega-3 fatty acids during pregnancy.
The Healthy Mothers guidelines say it is best to choose ocean fish,
such as salmon, tuna and sardines, which are highest in omega-3s.
Fish is rich in selenium, a mineral
that occurs at about five to 20 times the concentration of mercury.
When the two chemicals bind, "there is a growing body of evidence
that selenium in ocean fish may also counteract the potential negative
influence of mercury exposure," the panel said.
An FDA representative said that the
agency "plans to study the recommendations" but has not
changed its advice.
Flaxseed alternative
For women who don't like fish -- or feel caught in the
middle of the scientific debate -- options include other food rich in
omega-3s such as flaxseed and oil, or foods fortified with omega-3s,
such as eggs from chickens raised on feed rich in DHA.
Fish oil supplements are another
choice. Earlier this year, the European
Commission recommended that pregnant and lactating
women take 200 milligrams per day of DHA supplements.
© 2007 The Washington Post Company
URL: http://www.msnbc.msn.com/id/21072804/
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